Co-codamol Tablets 8mg/500mg (Pack of 32)

Co-codamol Tablets 8mg/500mg contain two different medicines called codeine phosphate and paracetamol.

Codeine belongs to a group of medicines called opioid analgesics which act to relieve pain. 

Co-codamol is used for the short term treatment of acute moderate pain caused by headaches, migraine, toothache, neuralgia, period pain and rheumatic pains when other painkillers have not worked.

This medication should be used with caution due to the potential for addiction. Codeine which is a key ingredient in this medicine, can cause addiction if you take it continuously for more than 3 days. This can give you withdrawal symptoms from the medicine when you stop taking it.

It should also be noted that co-codamol contains Paracetamol. This means you should not take any other paracetamol medication when using co-codamol as you will be at risk of overdosing on paracetamol.

If you take a painkiller for headaches for more than 3 days it can make them worse.

Wait at least 4 hours after you last took other painkillers before taking this medicine.

Co-codamol 8/500mg is used when other painkillers have not worked for acute to moderate pain such as;

• Headache (plus other cold flu symptoms such as temperature or a sore throat)
• Period pain
• Migraine
• Toothache

As co-codamol may cause drowsiness, you should see how the medication affects you before driving or using machinery. Do not drive whilst taking this medicine until you know how it affects you.

How do I know if I am addicted?

If you take this medicine according to the instructions on the pack it is unlikely that you will become addicted to the medicine.

However, if the following apply to you it is important that you talk to your doctor:

• You need to take the medicine for longer periods of time
• You need to take more than the recommended dose
• When you stop taking this medicine you feel very unwell but you feel better if you start taking the medicine again.

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How does co-codamol work?
Co-codamol has a dual mechanism of action. Paracetamol is thought to block chemical pathways to the brain which signal pain, while codeine works on pain receptors to block pain signalling to the rest of the body.

How long does it take for co-codamol to work?
You should notice pain relief around 1 hour after taking co-codamol.

Is co-codamol addictive?
Yes. As co-codamol contains the opioid codeine, it can be addictive if taken for long periods of time, or if abused. You should take this medication as directed by your doctor or pharmacist, and read the information leaflet on use.

Can I drink alcohol with co-codamol?
If you drink when taking any opioid medication including codeine, you are at risk of increasing the effects of drowsiness on the body. Otherwise, it should be okay to drink when taking co-codamol if you are not affected by the side-effects of drowsiness.

Can I drive when taking co-codamol?
You should wait to see how the medication affects you before driving or operating machinery. If you experience drowsiness after taking co-codamol, you should avoid driving.

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Stop taking co-codamol and see a doctor or go to a hospital straight away if:

• You get swelling of the hands, feet, ankles, face, lips or throat which may cause difficulty in swallowing or breathing. You could also notice an itchy, lumpy rash (hives) or nettle rash (urticaria). This may mean you are having an allergic reaction to co-codamol.
• You get serious skin reactions. Very rare cases have been reported.
• You have difficulty breathing and you feel dizzy.
• You have a fit (seizure).

Talk to your doctor straight away if you notice any of the following serious side effects:

Severe stomach pain, which may reach through to your back. This could be a sign of inflammation of the pancreas (pancreatitis). This is a very rare side effect.

Tell your doctor or pharmacist if any of the following side effects gets serious or lasts longer than a few days:

• Constipation, feeling sick (nausea), being sick (vomiting), dry mouth.
• Dizziness, light-headedness, drowsiness, confusion.
• Feeling overly happy (euphoria).
• A feeling of unease or dissatisfaction.
• Excessive constriction (shrinking) of the pupil of your eye.
• Difficulty in passing water.
• You get infections or bruises more easily than usual. This could be because of a blood problem.
• Becoming addicted to codeine.

For a full list of side effects, read the Patient Information Leaflet.

Other medicines and co-codamol

Tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines obtained without a prescription, including herbal products. This is because co-codamol and other medicines can affect the way each other works. Concomitant use of co-codamol and sedative medicines such as benzodiazepines or related drugs increases the risk of drowsiness, difficulties in breathing (respiratory depression), coma and may be life-threatening.

Because of this, concomitant use should only be considered when other treatment options are not
possible. 
It could be helpful to inform friends or relatives to be aware of the signs and symptoms stated above. Contact your doctor when experiencing such symptoms.

Tell your doctor or pharmacist if you are taking any of the following medicines, or have taken them in the past two weeks:

• Medicines which make you drowsy or sleepy (CNS depressants or a benzodiazepine) such as sleeping tablets, sedatives, tranquilisers, hypnotics and medicines used to treat anxiety or anaesthetics.
• Antidepressant medicines such as imipramine, amitriptyline, tranylcypromine, dosulepin, mirtazapine or chlorpromazine.

Tell your doctor or pharmacist if you are taking any other medicines:

• Medicines used to thin the blood such as warfarin.
• Chloramphenicol - an antibiotic used for infections.
• Metoclopramide or domperidone - used to stop you feeling sick (nausea) or being sick (vomiting).
• Cholestyramine - for lowering blood cholesterol levels.
• The oral contraceptive pill.

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Co-codamol.

If you get any side effects, talk to your doctor, our Rightdose pharmacists or nurse. This includes any possible side effects not listed in this leaflet.

You can help to make medicines safer by reporting any side-effects to the Yellow Card Scheme at www.mhra.gov.uk/yellowcard.

Before taking any medication, it is important to read the Patient Information Leaflet. You can find information leaflets for your medicines by typing them into the search bar at medicines.org, or by contacting us.

Patient Information Leaflet Co-Codamol 8mg/500mg Tablets (Pack of 32

This medicine contains paracetamol. Do not take anything else containing paracetamol while taking this medicine.

Co-codamol can be used in children over 12 years of age for the short-term relief of moderate pain that is not relieved by other painkillers such as paracetamol or ibuprofen alone.

Keep this medicine out of the sight and reach of children.

How to store Co-Codamol

• Do not use this medicine after the expiry date shown on the pack. The expiry date refers to the last day of that month.
• Store your medicine in the original packaging in order to protect from moisture. Do not store above 25°C.
• Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

Before using any medication, it is important to read the Patient Information Leaflet. You can find information leaflets for your medicines by typing them into the search bar at medicines.org, or by contacting us.

Directions:

Always use this medicine exactly as described in the patient information leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

• Do not take more than the recommended dose.
• Swallow the tablets whole with a drink of water.

Adults: 2 tablets every 4 to 6 hours when necessary up to a maximum of 8 tablets in 24 hours.

Use in children aged 16 to 18 years: 1 to 2 tablets every 6 hours when necessary up to a maximum of 8 tablets in 24 hours.
Use in children aged 12 to 15 years: 1 tablet every 6 hours when necessary to a maximum of 4 tablets in 24 hours.
This medicine should not be taken for more than 3 days. If the pain does not improve after 3 days, talk to your doctor for advice.

Co-codamol should not be given to children under 12 years of age due to the risk of severe breathing problems.

If you take more co-codamol than you should

Talk to a doctor at once if you take too much of this medicine even if you feel well. This is because too much paracetamol can cause delayed, serious liver damage. Remember to take any remaining tablets and the pack with you. This is so the doctor knows what you have taken.

If you forget to take co-codamol

If you forget to take a dose at the right time, take it as soon as you remember. However do not take a double dose to make up for a forgotten dose. Remember to leave at least 4 hours between doses.

If you stop taking co-codamol
This medicine contains codeine and can cause addiction if you take it continuously for more than 3 days. When you stop taking it you may get withdrawal symptoms. You should talk to your doctor or pharmacist if you think you are suffering from withdrawal symptoms.

Pregnancy and breastfeeding
Talk to your doctor before taking these tablets if:

• You are planning to breastfeed.
• You are pregnant, think you may be pregnant or plan to get pregnant.
• Do not take co-codamol while you are breastfeeding. Codeine and morphine pass into breast milk.

Warnings and precautions

This medicine contains paracetamol. Do not take anything else containing paracetamol while taking this medicine.

This medicine contains codeine which can cause addiction if you take it continuously for more than 3 days. This can give you withdrawal symptoms from the medicine when you stop taking it.

If you take a painkiller for headaches for more than 3 days it can make them worse.

Do not take co-codamol and tell your doctor if:

• You are taking medicines to treat depression called MAOIs (monoamine oxidase inhibitors) or have taken them in the last 2 weeks. MAOIs are medicines such as moclobemide, phenelzine, tranylcypromine.
• You are allergic to the active substances or any of the other ingredients in your medicine. Signs of an allergic reaction include a rash and breathing problems. There can also be swelling of the legs, arms, face, throat or tongue.
• The person going to take the tablets is under 12 years of age. Co-codamol must not be given to children under 12 years of age.
• You are under 18 years of age and have had your tonsils or adenoids removed due to obstructive sleep apnoea syndrome.
• You know that you metabolise codeine very rapidly into morphine.
• You are breastfeeding or planning to breastfeed.

Do not take co-codamol if any of the above applies to you. If you are not sure, talk to your doctor or
pharmacist before taking co-codamol.

Take special care and check with your doctor before taking co-codamol if:

• You are taking a benzodiazepine.
• You have severe kidney or liver problems.
• You suffer from seizures.

Codeine is transformed to morphine in the liver by an enzyme. Morphine is the substance that produces pain relief. Some people have a variation of this enzyme and this can affect people in different ways. In some people, morphine is not produced or produced in very small quantities, and it will not provide enough pain relief. Other people are more likely to get serious side effects because a very high amount of morphine is produced.

If you notice any of the following side effects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite.

Children and adolescents

Use in children and adolescents after surgery
Co-codamol should not be used for pain relief in children and adolescents after removal of their tonsils or adenoids due to Obstructive Sleep Apnoea Syndrome.
Use in children with breathing problems
Co-codamol is not recommended in children with breathing problems, since the symptoms of morphine toxicity may be worse in these children. If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before taking this medicine.

Ingredients:

The active substances are codeine phosphate and paracetamol. Each tablet contains 8mg of codeine phosphate and 500mg of paracetamol.

The other ingredients are maize starch, povidone, potassium sorbate, microcrystalline cellulose, stearic acid, magnesium stearate, talc, pregelatinised starch and purified water.

What Co-codamol 8/500 Tablets look like and contents of the pack

Flat white tablets, marked S/4 on one side. They come in cartons of 32 tablets.